Patient Care Coordinator
The patient care coordinator / customer service representative greets walk-in customers, answers incoming phone calls and is responsible for obtaining accurate information for each home medical equipment referral/order received based on the payers’ guidelines and specified criteria. The intake specialist will utilize the information listed in the Medicare Supplier Manual, the Local Coverage of Determination, the Articles and the Program Integrity Manual to determine the appropriate data to be collected and to insure that all coverage and billing criteria is met. The intake specialist will determine when an Advance Beneficiary Determination is needed and will discuss all payment criteria with the patient prior to delivery. Major responsibilities includes management of equipment referrals, obtaining physician orders and certificates of medical necessity, verifying insurance and coverage criteria, gathering medical documentation to demonstrate medical necessity and initiation of an Advance Beneficiary Notice when appropriate. The intake specialist will provide requested additional documentation needed by insurance carriers and work well with the other staff.
KEY RESPONSIBILITIES / ESSENTIAL FUNCTIONS Meets with patients and caregivers to review home medical equipment needs. Reviews and monitors all home medical equipment referrals. Performs data entry of patient information into the practice management software Performs verification of the patient’s health insurance coverage for the requested items Completes the insurance verification form accurately and discusses with patient prior to delivery. Monitors all physician orders insuring that the orders are timely, properly signed and dated as required by the Supplier Manual. Contacts patients at specific intervals to assess usage of supplies and equipment. Offers suggestions as appropriate to patient’s comments and responses. Properly documents all contact. Responsible for maintaining equipment guarantees/warranties. Updates Manager on inventory count weekly for equipment and supply needs. Verifies insurance, interprets coverage and calculates amount due by patient. Provides troubleshooting techniques to patients on equipment. Responsible for managing equipment repairs back to the manufacturer which involves gathering return authorization and packaging. Responds to patient calls and routes them appropriately, according to degree of urgency. Updates manager on problems and process improvement in regards to referrals and billing Works well with the team on phone calls and walk-ins and patient equipment needs. Light housekeeping and store closing process.
MINIMUM KNOWLEDGE, SKILLS, EXPERIENCE REQUIRED High School Diploma or GED degree required. CPAP and/or respiratory experience helpful. 20 wpm typing required. Must be proficient in the use of word processing programs (Microsoft Word / Google Documents) and spreadsheets (Excel, Google Sheets). Excellent customer service and organizational skills required. Needs to be self-directed and able to prioritize. Able to perform in a fast-paced environment. Must be able to read, write legibly, speak, and comprehend English .
WORKING CONDITIONS WORK CONTEXT Physical work conditions (Spend time sitting, spend time standing, Exposed to human body fluids, exposed to chemicals, etc.) Interpersonal relationships (Deals with unpleasant people, manages stress, must be helpful, flexible, and assertive with customers, handles conflict with effective problem-solving, functions as a productive team member, must have excellent verbal and written communication skills. Structural job characteristics (Importance of being accurate, work schedules, time pressure, etc.) PHYSICAL FACTORS Physical Activities: walking, talking, hearing, bending, twisting, stooping, lifting, kneeling, standing, sitting, crouching, or stooping with good balance for extended periods of time, grasping, pushing, pulling, repetitive motion, using hands to handle, control, or feel objects, tools or controls. Requirements: Light work. Exerting up to 45 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work. Must be able to perform the duties with or without reasonable accommodation. Hearing and vision must be normal or corrected to within normal range. Physical presence onsite is essential. OTHER JOB FACTORS Speed of Closure, Time Sharing, Finger Dexterity, and Speech Clarity. Concern for Others, Cooperation, Dependability, Initiative, Integrity, Self-Control, and Stress Tolerance. Independence, Relationships, and Support.
Job Type: Full-time
Pay: $14.00 - $16.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- 401(k) matching
- Employee discount
- Health insurance
- Paid time off
Schedule:
Work setting:
Application Question(s):
- Do you have any experience working in the durable / home medical equipment industry or working with verification of insurance coverage?
Experience:
- Customer Service: 1 year (Preferred)
Work Location: In person